Epilepsy and driving in South Australia--an assessment of compulsory notification.

We examined the licensing of drivers with conditions likely to endanger the public in a State in which doctors are obliged to notify the licensing authority. During 1991, 1460 medically endorsed licenses were cancelled. A sample of 245, including all 49 with epilepsy were mostly voluntary, the twenty exceptions with retained files being drivers with epilepsy. In the same period, 115 traffic accidents were attributed to illness, with the only four (4) investigated by the licensing authority being those with licenses endorsed "epilepsy" where a seizure was responsible. Compulsory notification appeared to result in the identification of epilepsy as the important medical reason for controlling licenses, but failed to recognise sleep disorders or alcoholism, both more significant causes of traffic accidents. In those accidents attributed to illness, almost no action was taken to review the medical fitness of drivers, suggesting a reliance on doctors rather than police or road safety authorities.